Deloitte survey: More Americans forgo medical care due to cost

By Michael Johnsen

WASHINGTON With unemployment rates remaining at an all-time high, 1-in-5 Americans chose not to seek medical care for a recent illness or injury, with 4-out-of-10 citing cost as the primary factor, according to a Deloitte Center for Health Solutions survey of more than 4,000 adults in the United States released Wednesday.

Deloitte's survey also revealed a decline in the number of consumers reporting to have visited a physician or healthcare professional in the past year; 79% of respondents sought medical attention in 2010 as compared with 85% who did likewise in 2009.

"As the burden of care continues to be shifted to the individual, and more Americans lose their jobs and their health insurance, we expect this trend will continue," stated Paul Keckley executive director, Deloitte Center for Health Solutions. "It will be interesting to see what happens in 2014 when the individual mandates requiring Americans to purchase health insurance kick in. Will we see a significant spike in visits to the doctor as more Americans join the ranks of the insured?"

Below are some of the alternative options to traditional care that consumers are exploring according to the survey:

15% of consumers reported visiting a retail clinic and 34% said they would do so if it cost 50% or less than the cost of a doctor's appointment;

More consumers are seeking alternative or natural remedies before seeing a physician (17% chose this option in 2010 compared with 12% in 2009); and

More consumers are supplementing their current regimes with alternative remedies (20% pursued this route in 2010 compared with 16% in 2009).

"As consumers increasingly begin to 'shop' for their care, they are seeking new options — price and convenience are key drivers," added Keckley. "Some consumers are heading to retail clinics for their flu shot instead of the doctor's office."

Some healthcare organizations have reported a decline in utilization of healthcare services in their most recent quarterly earnings reports. Reasons attributed include declines in admissions at some hospitals, decreases in visits to the doctor, less volume for some prescriptions and, in some cases, a reduction in medical tests ordered.

"While some healthcare organizations are seeing a dip in utilization, this is not the case across the board," said Russ Rudish, vice chairman and Deloitte healthcare provider practice leader. "In fact, some hospitals and healthcare providers have also reported increased demand for healthcare services. A lot depends on geography and patient population. Overall, the healthcare provider industry is cautiously optimistic that once deductibles are hit and health insurance kicks in, the volume of activity for medical services may return."

Anationally representative sample of 4,008 U.S. consumers ages 18 years and older were surveyed between Dec. 28, 2009 and Jan. 5, 2010, as part of Deloitte's third annual study examining healthcare consumers' attitudes, behaviors and unmet needs conducted by the Deloitte Center for Health Solutions. The results were weighted to assure proper proportional representation to the nation's population.